Baxendale Sallie, Thompson Pamela
Department of Clinical and Experimental Epilepsy, Institute of Neurology, Queen Square, London, UK.
Epilepsy Behav. 2005 Mar;6(2):207-11. doi: 10.1016/j.yebeh.2004.12.009.
Two hundred and ninety epilepsy surgery patients completed the Hospital Anxiety and Depression Scale and were assessed on a list learning task preoperatively and 1 year postoperatively. Deterioration and improvement in verbal memory were determined using reliable change indices (RCIs) at 80 and 90% confidence limits. Almost one third of patients (27%) experienced a deterioration in verbal learning. The number of left temporal lobectomy patients who had deteriorated outnumbered the right temporal lobectomy patients by 2:1. Significant improvements in verbal learning were seen in 21% of the right temporal lobectomy group and 10% of the left temporal lobectomy group. Patients who were seizure-free postoperatively were not more likely to experience a postoperative deterioration or improvement in memory than those who continued to experience seizures. No significant relationships were found between subjective ratings of postoperative memory function and objective indices of change. Reliable, objective indices of postoperative deterioration in memory function may bear little relation to the patient's subjective experience. This should be considered when statistical predictions are used as the basis of preoperative counseling.
290名癫痫手术患者完成了医院焦虑抑郁量表测试，并在术前和术后1年接受了一项列表学习任务评估。使用80%和90%置信区间的可靠变化指数（RCI）来确定言语记忆的恶化和改善情况。近三分之一的患者（27%）在言语学习方面出现了恶化。左颞叶切除术患者中出现恶化的人数是右颞叶切除术患者的两倍。右颞叶切除术组中有21%的患者言语学习有显著改善，左颞叶切除术组中有10%的患者有显著改善。术后无癫痫发作的患者与仍有癫痫发作的患者相比，术后记忆恶化或改善的可能性并无差异。术后记忆功能的主观评分与客观变化指标之间未发现显著关系。记忆功能术后恶化的可靠客观指标可能与患者的主观体验关系不大。在将统计预测用作术前咨询的依据时，应考虑到这一点。
